Psoriasis is a skin condition that causes skin redness and irritation. Most people with psoriasis have thick, red skin with flaky, silver-white patches called scales.
Plaque psoriasis; Psoriasis vulgaris; Guttate psoriasis; Pustular psoriasis
Psoriasis is very common. Anyone can develop it, but it most often begins between ages 15 to 35.
Psoriasis isn't contagious. This means it doesn't spread to other people.
Psoriasis seems to be passed down through families. Health care providers think it may be an autoimmune condition. This occurs when the immune system mistakenly attacks and inflames or destroys healthy body tissue.
Normal skin cells grow deep in the skin and rise to the surface about once a month. When you have psoriasis, this process takes place in 2 weeks rather than in 3 to 4 weeks. This results in dead skin cells building up on the skin's surface, forming the patches of scales.The following may trigger an attack of psoriasis or make it harder to treat:
Psoriasis may be worse in people who have a weak immune system. This may be due to:
Some people with psoriasis also have arthritis (psoriatic arthritis).
Psoriasis can appear suddenly or slowly. Many times, it goes away and then comes back.
The main symptom of the condition is irritated, red, flaky patches of skin. The medical term for the patches is plaques. Plaques are most often seen on the elbows, knees, and middle of the body. But they can appear anywhere, including on the scalp, palms, and soles of the feet.
The skin may be:
Other symptoms may include:
There are 5 main types of psoriasis:
Exams and Tests
Your provider can usually diagnose this condition by looking at your skin.
Sometimes, a skin biopsy is done to rule out other possible conditions. If you have joint pain, your provider may order x-rays.
The goal of treatment is to control your symptoms and prevent infection.
Three treatment options are available:
TREATMENTS USED ON THE SKIN (TOPICAL)
Most of the time, psoriasis is treated with medicines that are placed directly on the skin or scalp. These may include:
SYSTEMIC (BODY-WIDE) TREATMENTS
If you have very severe psoriasis, your provider will likely recommend medicines that suppress the immune system's faulty response. These medicines include methotrexate or cyclosporine. Retinoids can also be used.
Newer drugs called biologics are used when other treatments do not work. Biologics approved for the treatment of psoriasis include:
Some people may choose to have phototherapy:
If you have an infection, your provider will prescribe antibiotics.
Following these tips at home may help:
Psoriasis can be a life-long condition that can be controlled with treatment. It may go away for a long time and then return. With proper treatment, it will not affect your overall health. But be aware that there is a strong link between psoriasis and other health problems, such as heart disease.
When to Contact a Medical Professional
Call your provider if you have symptoms of psoriasis or if your skin irritation continues despite treatment.
Tell your provider if you have joint pain or fever with your psoriasis attacks.
If you have symptoms of arthritis, talk to your dermatologist or rheumatologist.
Go to the emergency room or call the local emergency number (such as 911) if you have a severe outbreak that covers all or most of your body.
There is no known way to prevent psoriasis. Keeping the skin clean and moist and avoiding your psoriasis triggers may help reduce the number of flare-ups.
Providers recommend daily baths or showers for people with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack.
Lebwohl MG, van de Kerkhof PCM. Psoriasis. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 203.
Menter A, Gottlieb A, Feldman SR, et al. Guidelines for the management of psoriasis and psoriatic arthritis. Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008;5:826-850. PMID: 18423260 www.ncbi.nlm.nih.gov/pubmed/18423260.
Menter A, Korman NJ, Elmets CA, et al. American Academy of Dermatology guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies. J Am Acad Dermatol. 2009;60:643-659. PMID: 19217694 www.ncbi.nlm.nih.gov/pubmed/19217694.
Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy. J Am Acad Dermatol. 2011;1:114-135. PMID: 19811850 www.ncbi.nlm.nih.gov/pubmed/19811850.